Kabagenyi Allen, Ndugga Patricia, Wandera Stephen Ojiambo, Kwagala Betty
Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda.
BMC Public Health. 2014 Mar 28;14:286. doi: 10.1186/1471-2458-14-286.
Family planning programs have recently undergone a fundamental shift from being focused on women only to focusing on men individually, or on both partners. However, contraceptive use among married men has remained low in most high-fertility countries including Uganda. Men's role in reproductive decision-making remains an important and neglected part of understanding fertility control both in high-income and low-income countries. This study examines whether discussion of family planning with a health worker is a critical determinant of modern contraceptive use by sexually active men, and men's reporting of partner contraceptive use.
The study used data from the 2011 Uganda Demographic and Health Survey comprising 2,295 men aged 15-54 years. Specifically, analyses are based on 1755 men who were sexually active 12 months prior to the study. Descriptive statistics, Pearson's chi-square test, and logistic regression were used to identify factors that influenced modern contraceptive use among sexually active men in Uganda.
Findings indicated that discussion of family planning with a health worker (OR=1.85; 95% CI: 1.29-2.66), region (OR=0.41; 95% CI: 0.21-0.77), education (OR=2.13; 95% CI: 1.01-4.47), wealth index: richer (OR=2.52; 95% CI: 1.58-4.01), richest (OR=2.47; 95% CI: 1.44-4.22), surviving children (OR=2.04; 95% CI:1.16-3.59) and fertility preference (OR=3.50; 95% CI: 1.28-9.61) were most significantly associated with modern contraceptive use among men.
The centrality of the role of discussion with health workers in predicting men's participation in family planning matters may necessitate creation of opportunities for their further engagement at health facilities as well as community levels. Men's discussion of family planning with health workers was significantly associated with modern contraceptive use. Thus, creating opportunities through which men interact with health workers, for instance during consultations, may improve contraceptive use among couples.
计划生育项目最近经历了根本性转变,从仅关注女性转向单独关注男性或关注夫妻双方。然而,在包括乌干达在内的大多数高生育率国家,已婚男性的避孕措施使用率仍然很低。在高收入和低收入国家,男性在生殖决策中的作用仍然是理解生育控制的一个重要但被忽视的部分。本研究调查了与卫生工作者讨论计划生育是否是性活跃男性使用现代避孕措施以及男性报告伴侣使用避孕措施的关键决定因素。
该研究使用了2011年乌干达人口与健康调查的数据,其中包括2295名年龄在15至54岁之间的男性。具体而言,分析基于在研究前12个月内有性活动的1755名男性。描述性统计、皮尔逊卡方检验和逻辑回归被用于确定影响乌干达性活跃男性使用现代避孕措施的因素。
研究结果表明,与卫生工作者讨论计划生育(比值比=1.85;95%置信区间:1.29 - 2.66)、地区(比值比=0.41;95%置信区间:0.21 - 0.77)、教育程度(比值比=2.13;95%置信区间:1.01 - 4.47)、财富指数:较富裕(比值比=2.52;95%置信区间:1.58 - 4.01)、最富裕(比值比=2.47;95%置信区间:1.44 - 4.22)、存活子女数量(比值比=2.04;95%置信区间:1.16 - 3.59)和生育偏好(比值比=3.50;95%置信区间:1.28 - 9.61)与男性使用现代避孕措施最显著相关。
与卫生工作者讨论在预测男性参与计划生育事务方面的核心作用,可能需要在医疗机构和社区层面创造更多机会让他们进一步参与。男性与卫生工作者讨论计划生育与使用现代避孕措施显著相关。因此,通过例如在咨询期间创造男性与卫生工作者互动的机会,可能会提高夫妻的避孕措施使用率。